To support his view that EGDT should be considered the standard of care, Dr Rivers2 points to > 20 subsequent studies showing improved outcomes after instituting a sepsis protocol. Not one of these studies involved the introduction of EGDT the way it was delivered in the original trial. Instead, investigators typically initiated a broad sepsis bundle, often involving education, process improvement, or even a hospital-wide rapid-response team.3,4 It does not seem fair to conflate EGDT with an entire range of improved care practices. Early recognition, early treatment, and a lot of attention by health-care practitioners could improve survival, independent of central venous oxygen saturation (Scvo2)-directed therapy. In two of these studies, after implementation of an integrated sepsis treatment protocol, antibiotics were given faster and were more likely to be adequate.3,5 Is that EGDT or just good medicine?